School of Health Policy & Management, Faculty of Health, HNES Bldg., 413, York University, 4700 Keele Street, Toronto, ON M3J 1P3, Canada.
Health Serv Res. 2010 Jun;45(3):607-32. doi: 10.1111/j.1475-6773.2010.01102.x. Epub 2010 Mar 10.
To examine the relationship between organizational leadership for patient safety and five types of learning from patient safety events (PSEs).
Forty-nine general acute care hospitals in Ontario, Canada.
A nonexperimental design using cross-sectional surveys of hospital patient safety officers (PSOs) and patient care managers (PCMs). PSOs provided data on organization-level learning from (a) minor events, (b) moderate events, (c) major near misses, (d) major event analysis, and (e) major event dissemination/communication. PCMs provided data on organizational leadership (formal and informal) for patient safety.
Hospitals were the unit of analysis. Seemingly unrelated regression was used to examine the influence of formal and informal leadership for safety on the five types of learning from PSEs. The interaction between leadership and hospital size was also examined.
Formal organizational leadership for patient safety is an important predictor of learning from minor, moderate, and major near-miss events, and major event dissemination. This relationship is significantly stronger for small hospitals (<100 beds).
We find support for the relationship between patient safety leadership and patient safety behaviors such as learning from safety events. Formal leadership support for safety is of particular importance in small organizations where the economic burden of safety programs is disproportionately large and formal leadership is closer to the front lines.
研究患者安全组织领导力与五种类型的患者安全事件(PSE)学习之间的关系。
加拿大安大略省的 49 家普通急性护理医院。
采用横断面调查医院患者安全官员(PSO)和患者护理经理(PCM)的非实验设计。PSO 提供了关于组织层面从(a)小事件、(b)中等事件、(c)重大接近失误、(d)重大事件分析和(e)重大事件传播/沟通中学习的信息。PCM 提供了关于患者安全的正式和非正式组织领导力的数据。
医院是分析单位。采用似乎不相关的回归来检查安全正式和非正式领导力对五种类型的 PSE 学习的影响。还检查了领导力和医院规模之间的相互作用。
患者安全的正式组织领导力是从小型、中型和重大接近失误事件以及重大事件传播中学习的重要预测因素。对于小于 100 张病床的小医院,这种关系更为明显。
我们发现患者安全领导力与患者安全行为之间存在关系,例如从安全事件中学习。安全方面的正式领导支持在小组织中尤为重要,因为安全计划的经济负担不成比例地增加,并且正式领导更接近前线。